Marino Andrea, Munafò Antonio, Augello Egle, Bellanca Carlo Maria, Bonomo Carmelo, Ceccarelli Manuela, Musso Nicolò, Cantarella Giuseppina, Cacopardo Bruno, Bernardini Renato
Department of Biomedical and Biotechnological Science (BIOMETEC), University of Catania, 95123 Catania, Italy.
Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95123 Catania, Italy.
Infect Dis Rep. 2022 May 11;14(3):360-371. doi: 10.3390/idr14030040.
Two years have passed since WHO declared a pandemic state for SARS-CoV-2 infection. COVID-19 pathogenesis consists of a first viral phase responsible for early symptoms followed by an inflammatory phase, cytokine-mediated, responsible for late-onset manifestations up to ARDS. The dysregulated immune response has an outstanding role in the progression of pulmonary damage in COVID-19. IL-6, through the induction of pro-inflammatory chemokines and cytokines, plays a key role in the development and maintenance of inflammation, acting as a pioneer of the hyperinflammatory condition and cytokine storm in severe COVID-19. Therefore, drugs targeting both IL-6 and IL-6 receptors have been evaluated in order to blunt the abnormal SARS-CoV-2-induced cytokine release. Sarilumab, a high-affinity anti-IL-6 receptor antibody, may represent a promising weapon to treat the fearsome hyperinflammatory phase by improving the outcome of patients with moderate-to-severe COVID-19 pneumonia. Further prospective and well-designed clinical studies with larger sample sizes and long-term follow-up are needed to assess the efficacy and the safety of this therapeutic approach to achieve improved outcomes in COVID-19.
世界卫生组织宣布新型冠状病毒2感染为大流行状态至今已有两年。新冠病毒疾病的发病机制包括第一个病毒阶段，该阶段导致早期症状，随后是炎症阶段，由细胞因子介导，导致直至急性呼吸窘迫综合征的迟发性表现。失调的免疫反应在新冠病毒疾病肺部损伤的进展中起重要作用。白细胞介素-6通过诱导促炎趋化因子和细胞因子，在炎症的发展和维持中起关键作用，在重症新冠病毒疾病中作为过度炎症状态和细胞因子风暴的先驱。因此，针对白细胞介素-6和白细胞介素-6受体的药物已被评估，以抑制异常的新冠病毒诱导的细胞因子释放。萨瑞鲁单抗，一种高亲和力抗白细胞介素-6受体抗体，可能是通过改善中重度新冠病毒肺炎患者的预后，来治疗可怕的过度炎症阶段的一种有前景的药物。需要进一步进行样本量更大且有长期随访的前瞻性和精心设计的临床研究，以评估这种治疗方法在新冠病毒疾病中实现改善预后的疗效和安全性。
